Understanding biopsychosocial factors influencing cigarette smoking among transgender and gender diverse individuals living in Argentina: a qualitative study.

BACKGROUND: The prevalence of cigarette smoking among transgender women in Argentina is 42%, more than double the rate compared to cisgender women. OBJECTIVES: To understand biopsychosocial factors influencing cigarette smoking among transgender and gender-diverse (TGD) individuals living in Argentina. METHODS: Between December 2023 and January 2024, 19 qualitative semi-structured interviews were conducted face-to-face with TGD individuals. TGD peer navigators recruited participants using community-based strategies. The biobehavioral model of nicotine addiction was the theoretical framework for the qualitative analysis. RESULTS: we identified important biological, psychological, and social factors. Biological factors included: (1) Negative impact of cigarette smoking on health (e.g., medical gender affirmation), and (2) nicotine dependence. Psychological factors included: (1) Emotions (e.g., loneliness), (2) psychological disorders, (3) coping strategies (e.g., gender minority stress), (4) cognition and beliefs (e.g., psychological gender affirmation), (5) routine behavior, and (6) substance use. Social factors included: (1) social influence, (2) social acceptance of smoking, (3) social support, (4) gender-based stigma, discrimination, and violence, and (5) contextual factors (i.e., work environments). CONCLUSION: These results provide important insights to be considered when developing a tailored smoking cessation intervention for TGD individuals living in Argentina.